Curbing West Africa’s Ebola outbreak

DAKAR, 26 mars 2014

As health authorities and aid groups work to contain the spread of Ebola in Guinea which has killed 59 people and infected scores of others since January, suspected cases have emerged in neighbouring Liberia, prompting calls for a regional response.

Haemorrhagic fever symptoms first appeared in Guinea’s southern forested region. Eighty-six people have so far been infected. Authorities are urging restriction of movement and observance of hygiene to prevent further infections.

The cases have mainly been reported in the four southern districts of Guéckédou, Macenta, Nzérékoré and Kissidougou near the border with Sierra Leone and Liberia. Médecins Sans Frontières (MSF) has dispatched some 33 tons of medicines and equipment to Guinea to help curtail the epidemic which is infecting 1-3 people a day.

“It’s happening along the border, so what we’ve been doing now is to start a collaboration between these neighbouring countries,” said Francis Kasolo, director of the World Health Organization’s (WHO) Disease Prevention and Control Unit in Africa. “Conferences are being held between these three countries to ensure that whenever there is a suspected case it can be identified quickly and appropriate response can be taken.”

In Guinea’s Guéckédou area, district health chief Moussa Kolié said: “We have begun training nurses to help contain as much as possible the spread of new cases.” Funeral gatherings and unnecessary hospital visits were being discouraged, he said.

MSF has deployed medical teams to Guinea’s affected areas, where the organization is setting up isolation centres and people thought to have been in contact with those infected are traced and also quarantined.

“This is the only way to try and contain the spread,” Reinaldo Ortuno, a doctor with MSF, told IRIN.

Ortuno pointed out that the failure of the epidemiology surveillance system explains the high number of cases registered so far.

Sakoba Kéïta, head of Guinea’s Health Ministry disease prevention unit, called for the observance of basic hygiene and avoiding eating meat the origin of which is unknown.

“We are calling on those who attended funerals of those who died of this disease to present themselves for identification and wash all their items with chlorine solution… and ensure they get medical observation for at least three weeks to one month,” Kéïta said.

Ebola is transmitted to humans through contact with blood, body fluids or organs of infected animals. Infections have been reported in Africa following the handling of chimpanzees, gorillas, fruit bats, or antelopes and porcupines in tropical forests, according to WHO.

Liberia

Liberia’s Health Ministry confirmed that five people have died of suspected Ebola haemorrhagic fever in the north of the country. The four women and one child are said to have come from Guinea to seek treatment in Foya in Liberia’s northern Lofa County. Chief Medical Officer Bernice Dahn said a medical team had been sent to the area.

“The team is already investigating the situation, tracing contacts, collecting blood samples and sensitizing local health authorities on the disease,” Dahn told reporters.

“This disease has really caught us off-guard. People are now avoiding each other in the town. There are no more greetings. Panic is overshadowing hospitality”

However, the deaths have yet to be confirmed as being due to Ebola. “We need to confirm these cases to know what we are dealing with,” said Peter Clement, WHO’s acting country director.

“The key message is that … we shouldn’t panic because it can be prevented. All of us should be responsible. It can be contained. We are working hand-in-hand with the Ministry of Health to be able to mobilize the necessary support,” Clement said.

Liberia’s Health Minister Walter Gwenigale said market traders who cross to Guinean markets should avoid venturing into the affected districts of Guinea. “If you are living along the border and you really do not have any reason to go into towns where this disease is reported, you do not have to go there,” he said.

Guinea’s public health system is weak and has been reliant on donor funding which was suspended due to political instability, affecting public services.

“The government does not even have a laboratory to quickly verify the nature of this [Ebola] disease. This is why the death toll is high,” said Conakry resident Fodé Camara

In Liberia, the health sector has yet to fully recover from the devastation of the country’s civil war. “Most of the hospitals, clinics and equipment were destroyed during the years of civil conflict. The strengthening of the health sector faced financial problems. The country heavily relied on the international community for health infrastructure and aid,” said health worker Martha Paye.

“This disease has really caught us off-guard”

Authorities in Guinea and Liberia have urged citizens not to panic, but many are scared of contracting Ebola, which has emerged in West Africa for the first time.

“This disease has really caught us off-guard. People are now avoiding each other in the town. There are no more greetings. Panic is overshadowing hospitality. Bodies can’t be washed [before burial], but that is alright because prevention is better than cure,” said Guéckédou resident Atanasse Tinkiano.

Guinea’s government spokesman Damantang Albert Camara said health and public awareness measures were being taken and “I think that if all these measures are respected, the worst can be avoided.”

“I am deeply worried,” said Liberian journalist Jallah Grayfield. “What is mostly disturbing is that the disease has no cure.”